Consecutive laser in situ keratomileusis and accelerated corneal crosslinking in highly myopic patients: preliminary results

Eur J Ophthalmol. 2014 Dec 5;0. doi: 10.5301/ejo.5000543. Online ahead of print.


Purpose: To report the preliminary results of an evaluation of the safety and predictability of Lasik Xtra, a technique combining laser in situ keratomileusis (LASIK) and accelerated corneal crosslinking, in highly myopic patients.

Methods: In this consecutive comparative case series, 70 consecutive eyes undergoing LASIK for correction of high myopia (-8.00 D to -19.00 D manifest refractive spherical equivalent) were prospectively recruited and treated with Lasik Xtra and compared with a retrospective consecutive control group of 64 eyes who had undergone LASIK alone for correction of high myopia. The follow-up was 3 months. Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refraction.

Results: A total of 61% of LASIK only eyes achieved UDVA of 20/25 or better, compared to 98% of Lasik Xtra eyes (p<0.001) at 3 months. A greater percentage of eyes were within ±0.50 of the intended correction in the Lasik Xtra group (88%) than in the LASIK only group (65%) at 3 months (p = 0.005). Linear regression of the scatterplot of attempted versus achieved correction reveals a coefficient of determination of 0.83 in the LASIK only group vs 0.99 in the Lasik Xtra group. A trend (p = 0.051) towards greater refractive drift in the LASIK group (-0.13 D) vs the Lasik Xtra group (-0.04 D) was observed. No adverse events were observed in either group.

Conclusions: Lasik Xtra did not reduce the refractive accuracy of the LASIK procedure. The addition of crosslinking may induce early stabilization of the cornea after LASIK, improving the predictability of refractive outcomes in highly myopic subjects.